本文選題：輸尿管鏡碎石術(shù) + uNGAL　； 參考：《寧夏醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的通過(guò)測(cè)定腎功能受損指標(biāo)尿液中性粒細(xì)胞明膠酶相關(guān)運(yùn)載蛋白（NGAL）及α１微球蛋白（α1-MG）的變化，探討輸尿管鏡鈥激光碎石術(shù)后早期腎功能損害的影響因素。研究NGAL及α1-MG在輸尿管鏡術(shù)后的變化規(guī)律及臨床意義，為選擇檢測(cè)輸尿管鏡術(shù)后腎功能損傷的指標(biāo)提供依據(jù)。 方法篩選輸尿管結(jié)石患者40例，收集其輸尿管鏡碎石術(shù)前2h、術(shù)后2、6、12、24、48、72h的尿液標(biāo)本，，用ELISA法檢測(cè)NGAL、α1-MG的濃度，分析尿液中NGAL、α1-MG的變化及其與手術(shù)時(shí)間、泵的壓力的相關(guān)性。 結(jié)果不同患者的各時(shí)間點(diǎn)尿液NGAL和α1-MG濃度的變化有顯著差異（P0.05）。40例患者輸尿管鏡碎石術(shù)后尿液NGAL及α1-MG濃度較術(shù)前有明顯變化，且表現(xiàn)出一定規(guī)律性。尿液NGAL在術(shù)后2h開(kāi)始上升，與基線值比較差異有統(tǒng)計(jì)學(xué)意義(P0．05)，并在12h達(dá)到峰值，隨后開(kāi)始下降，至72h時(shí)仍高于基線值，差異仍有統(tǒng)計(jì)學(xué)意義(PO，05)；尿液α1-MG濃度晚于NGAL于術(shù)后12h方才開(kāi)始升高，并于術(shù)后24h達(dá)峰值，至術(shù)后72h仍高于基線值，差異均有統(tǒng)汁學(xué)意義(P0．05)，何時(shí)將至基線水平無(wú)統(tǒng)計(jì)學(xué)意義。同時(shí)尿液NGAL、α1-MG變化水平分別與手術(shù)時(shí)間、灌注壓力呈正相關(guān)。 結(jié)論輸尿管鏡碎石術(shù)后尿液NGAL、α1-MG變化水平是反映腎早期損害的敏感指標(biāo)并與手術(shù)時(shí)間、灌注壓力有相關(guān)性。提示尿液NGAL與α1-MG是判定輸尿管鏡鈥激光碎石術(shù)后早期腎損傷的有效監(jiān)測(cè)指標(biāo)，為臨床診治腎損傷提供客觀依據(jù)。
[Abstract]:Objective to determine the changes of urinary neutrophil gelatinase-associated transport protein (NGAL) and 偽 _ 1-microglobulin (偽 _ 1-MG) in patients with renal function impairment and to explore the influencing factors of early renal function damage after ureteroscopic holmium: YAG laser lithotripsy. To study the changes and clinical significance of NGAL and 偽 1-MG after ureteroscopy, and to provide evidence for the selection of indicators for the detection of renal function injury after ureteroscopy. Methods 40 patients with ureterolithiasis were selected. The urine samples were collected 2 hours before ureteroscopic lithotripsy and 72 hours after ureteroscopic lithotripsy. The concentrations of NGALand 偽 1-MG were detected by Elisa, and the changes of NGALand 偽 1-MG in urine and their correlation with operation time and pump pressure were analyzed. Results the concentrations of NGAL and 偽 1-MG in urine of 40 patients with ureteroscopic lithotripsy were significantly different from those before ureteroscopic lithotripsy at different time points (P0.05), and there were some regularity in urine NGAL and 偽 1-MG concentrations after ureteroscopic lithotripsy. Urine NGAL began to rise at 2 hours after operation, the difference was statistically significant compared with baseline value (P0.05), and reached the peak at 12 hours, then began to decrease, and was still higher than the baseline value at 72 hours, the difference was still statistically significant (POP05). The concentration of urine 偽 1-MG increased only 12 hours after the operation than NGAL, and reached the peak at 24 hours after the operation, and was still higher than the baseline value at 72 hours after the operation. The difference was statistically significant (P0.05), but there was no statistical significance when the level of 偽 1-MG reached the baseline level. At the same time, the levels of urinary NGALand 偽-1-MG were positively correlated with the time of operation and perfusion pressure. Conclusion the changes of urinary NGALand 偽 1-MG levels after ureteroscopic lithotripsy are sensitive markers for early renal damage and are correlated with the operative time and perfusion pressure. These results suggest that urinary NGAL and 偽 1-MG are effective indicators for early renal injury after ureteroscopic holmium laser lithotripsy, and provide an objective basis for clinical diagnosis and treatment of renal injury.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R699

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